Cowden syndrome. Managing multiple skeletal metastases of different origin: a case report.
BACKGROUND
Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, characterised by both benign and malignant tumours affecting multiple systems.


METHODS
We present a 47-year-old female patient with thigh pain that was diagnosed with Cowden syndrome 20 years ago and developed multiple and different skeletal metastases which became resistant to radio-chemotherapy. A percutaneous plate fixation of the distal femur with an intralesional excision and cementoplasty of the metastasis was performed initially. This was combined with a cemented total hip arthroplasty using an Exeter long revision stem and a cementoplasty of the femoral canal for the proximal lesions.


CONCLUSIONS
A meticulous approach to her complex metastatic disease resulted in successful palliative prophylactic reconstructive surgery that improved her quality of life, allowing her independent pain free walking for 12 months.
Angoules
Antonios
A
Academic Orthopaedic Unit, Leeds General Infirmary, Leeds School of Medicine, Leeds, LS1 3EX, UK. etsiridis@doctors.org.uk.
Tsapakis
Evangelia Maria
EM
Polyzois
Ioannis
I
Gamie
Zakareya
Z
Rankine
James Julian
JJ
Tsiridis
Eleftherios
E